Black pregnant women's anxiety increased during COVID-19

a pregnant woman standing outside
New research found that Black pregnant women’s anxiety increased due to the COVID-19 pandemic, caused by several factors beyond fear of infection.

The COVID-19 pandemic had a profound impact on pregnant people around the world. At the same time, COVID disproportionately impacted communities of color, with Black people experiencing higher rates of infection and death.

Pregnant people of color were already facing racial disparities in health outcomes before the pandemic started. Not surprisingly, the impact of COVID-19 has been felt disproportionately by Black pregnant people.

A new study by Bixby researchers April J. Bell and Patience Afulani with colleagues at the University of Michigan used online surveys to look at the impact of COVID-19 on pregnant Black women in the early escalation phase of the pandemic in the US.

The researchers found that anxiety increased a result of COVID, with several drivers of anxiety beyond fear of getting sick. Uncertainty, lack of support, perceived quality of care, and anxiety worked together to define women’s experiences of pregnancy at that time.

“It (COVID) destroyed everything about having a nice and enjoyable pregnancy.” - 20-years-old

“Giving birth for the first time, during a pandemic, in a hospital with people who have Covid-19, without my support people, is anxiety-inducing.” - 40-years-old

This study adds to a growing body of literature documenting how Black women report inequities in access to reproductive health care. Women of color often have less access to pregnancy-related care, may not be treated well when they do receive care, and have worse pregnancy outcomes than white patients—all while COVID was disproportionately impacting their communities.

Despite being a relatively well-educated sample of Black women from around the US, many of the women spoke about fears of discrimination, needing to advocate for themselves, and heightened anxiety as a result. This finding reinforces that perceptions and fear of discrimination in health care are pervasive for Black women, regardless of their level of education or other relative social and economic advantages.

This research suggests that in times of uncertainty such as the early days of the COVID-19 pandemic, it’s more important than ever to provide thoughtful, supportive care to pregnant people of color who are primed for negative health care experiences. Understanding that women of color are often expecting to be treated poorly should inform approaches to providing care. It’s clear that expectations, anxiety, uncertainty and perceptions of quality of care are inextricably linked.